In treating hyperkalemia, which medication is administered to shift potassium intracellularly?

• A. Insulin and glucose
• B. Calcium gluconate
• C. Kayexalate
• D. Dialysis

Answer: (A)

In the management of hyperkalemia, insulin combined with glucose is a key treatment strategy to shift potassium from the extracellular space back into the cells. Insulin facilitates the uptake of glucose into the cells, which in turn prompts the sodium-potassium pump to move potassium ions into the intracellular compartment. This is particularly effective in emergency situations to quickly lower serum potassium levels and prevent complications associated with high potassium, such as cardiac arrhythmias.

Glucose is administered alongside insulin to prevent hypoglycemia, which can occur as insulin lowers blood sugar levels. Insulin's role is directly related to its influence on cellular metabolism and the movement of potassium across cellular membranes, making it an effective and rapid intervention in acute hyperkalemia cases.

While other options like calcium gluconate can stabilize the cardiac membrane in cases of severe hyperkalemia and medications such as Kayexalate or dialysis can help remove potassium from the body, they do not directly shift potassium intracellularly. Thus, insulin and glucose represent the most immediate corrective measure for elevated potassium levels at a cellular level.